Community-Acquired Pneumonia (CAP) Pathway Background and Objectives Community-Acquired Pneumonia (CAP) is one of the most common pediatric diagnoses, affecting approximately 2% of children annually. In 2011, the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America released a new practice guideline with evidence-based recommendations for the management of CAP in otherwise healthy infants and children. Due to decreasing S. pneumoniae resistance, there is less need for broad-spectrum antibiotics to treat CAP. The new guidelines reflect this change in antimicrobial resistance. There is also new evidence to suggest the usage of procalcitonin and its role in determining antibiotic need, as well as the utility of MRSA nasal PCR to determine the need for MRSA coverage. The objectives of this pathway are to: Decrease variation in antibiotic usage Decrease unnecessary use of broad spectrum antibiotics Decrease unnecessary use of azithromycin Optimize ampicillin/amoxicillin dosing for local pneumococcal resistance Decrease antibiotic usage to shortest effective duration Increase appropriate use of Oseltamivir Algorithm Download CAP Pathway Algorithm Updated February 12, 2021 Quality Metrics Percentage of eligible patients treated per pathway Percentage of patients with appropriate inpatient antibiotic selection Percentage of patients with correct inpatient discharge antibiotic selection Percentage of patients with correct inpatient discharge antibiotic dosage Average duration of antibiotic coverage (inpatient + outpatient prescription) Percentage patients who had a CBC, who also had procalcitonin drawn Percentage of patients with a procalcitonin level ≤0.25 who receive an antibiotic Percentage of patients who receive vancomycin or linezolid Percentage of patients with negative MRSA PCR, and vancomycin or linezolid discontinued Admit length of stay (days) Educational Module Download CAP Educational Module Updated February 12, 2021 Key References: Bradley JS, Byington CL, Shah SS, et al. The management of community-aquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Disease Society and the Infectious Diseases Society of America. Clin Infect Dis. 2011 Oct;53(7):e25-76. Newman RE, Hedican EB, Herigo JC, Williams DD, Williams AR, Newland JG. Impact of a Guideline on Management of Children Hospitalized With Community-Acquired Pneumonia. 2012 Mar;129(3):e597-604. Pathway Contacts Jennifer Girotto, PharmD Grace Hong, APRN Anand Sekaran, MD Disclaimer The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case. View all Clinical Pathways >
